Adult Medicaid Manual MA-2221 COUNTY RESIDENCE

II. DETERMINING COUNTY RESIDENCE

A. Non-institutional Living Arrangement

An individual has residence in the county in which he lives. This applies even if the individual owns a home in a different county or state.

B. Institutional Living Arrangement

An individual in a hospital, mental institution, nursing facility (SNF, ICF-MR), Adult Care Home (rest homes/domiciliary care facility/assisted living) or a similar institution/facility:

1. Is a resident of the county in which he lived immediately prior to entering the facility.

2. If an individual moves from another state directly into an institutional living arrangement, the individual is a resident of the county in which the facility is located. If the individual moves to more than one institution/facility, the county of residence is the county where the first institution/facility is located.

NOTE: Residence in an adult care home does not establish county residence, even when the individual was a private paying adult care home resident. Establish his county of residence prior to entering the adult care home.

REISSUED 08/01/09-CHANGE NO. 12-09

(II)

C. Temporary Absence From County/Home

Temporary absence from the county of residence, with subsequent return or intent to return, does not change the residence, unless another county has determined that the person is a resident there.

1. An individual may be temporarily absent from the home without interruption of the continuity of Medicaid. If it is discovered that an individual is not temporarily absent, evaluate county of residence following instructions in.A. or B. above.

2. Reason for temporary absence from the county/home include but are not limited to:

a. Visits to friends/relatives in another county: If the visit exceeds three months, the caseworker verifies the following:

(1) Whether the recipient intends to return home. Request a signed statement from the client which states intent to return home, and

(2) Verification that rent/house utility payments are being made, and

(3) Receipt of mail continues.

b. Reason for continuing absence: Request assistance from the second county to document the reason for continued absence.

Reasons for continued absence include, but are not limited to:

(1) Illness of the recipient.

(2) Illness and need for continuing care of someone the recipient had been visiting in another county.

07/01/04

(II.)

D. Individual With No Permanent Address

A person with no fixed or permanent address is a resident of the county where he states his intent to remain. If the individual is incapable of stating his intent to remain, he is a resident in the county in which he is found.

E. Disputed County of Residence

If the county of residence is disputed, counties should contact their Medicaid Program Representative (MPR) for settlement. The county in which the applicant files the application must proceed to process the application without delay. Upon review of all facts in the case, the MPR(s) will notify the counties of the decision regarding residence.

If the county, which processed the application, is not the county of residence, then that county should immediately contact the Claims Analysis Section of DMA.

Additionally, the county should identify any claims charged in error to their county by reviewing the "Recipient Payment Register." Once claims are identified, notify the Claims Analysis Section of DMA in writing of the charges. Include the recipient's name, individual identification number, and dates of service.

NOTE: This is different from the situation in which a county took a courtesy application and the county of residence refuses to accept the application. For this situation, see MA-2300, Initial Contact.